JOURNAL OF MAZANDARAN UNIVERSITY OF MEDICAL SCIENCES
Year:2016 | Volume:26 | Issue:141|Papers Count:32

Background and purpose: Endometriosis is a benign disorder defined by the presence of endometrial tissue out of pelvic cavity and is related to debilitating pelvic pain and infertility. MiRNAs, are a cluster of small endogenous noncoding RNA that bind to 3׳ UTR of target mRNA and cause mRNA degradation or repressing translation of mRNA. Mir-126 is a type of miRNA that is involved in many vital processes such as invasion and angiogenesis. In this study, mir-126 rs4636297 G/A gene polymorphism was compared between infertile women with endometriosis and healthy women.Materials and methods: This analytical study was done in 72 infertile women with endometriosis and 252 healthy women as a control group. After extraction of genomic DNA from peripheral blood samples, desired polymorphism was genotyped using Tetra-ARMS-PCR method.Statistical analysis was performed using SPSS ver.17. Genotype distributions and allelic frequencies of mir-126rs4636297 gene polymorphism were compared between patient and control groups by Logistic regression analysis.Results: A significant association was found between A allele of rs4636297 mir-126 polymorphism and endometriosis (OR: 0.6, 95% CI: 0.4-0.84, P=0.005). In the dominant model of A allele (comparison between AA+AG VS. GG), AA+AG had protective effect on endometriosis (OR: 0.48, 95% CI: 0.28-0.82, P=0.007).Conclusion: There is a significant association between rs4636297 mir-126 polymorphism and susceptibility to endometriosis.

Background and purpose: Since long time ago herbal products and spices have been used as powders, essential oils (EOs), and extracts. They consist of antimicrobial components and could be applied as natural food preservatives. In the present work, the antiviral effect of cinnamon, rosemary, and zataria EOs has been investigated against norovirus surrogates including feline calicivirus (FCV) and murine norovirus (MNV).Materials and methods: Different concentrations of EOs were individually mixed with each virus at titers of ca.7-8 log TCID50/ml and incubated for 2 h at 4oC and 37oC. The infectivity of the recovered viruses was evaluated by cell-culture assays.Results: At 37oC, 3% of cinnamon, 2.5% of rosemary and 0.1% of zataria EOs decreased the FCV titers by 2.38, 3.38, and 4.51 log TCID50/ml, respectively. At lower concentrations they were found to be less effective. Also, different concentrations of EOs decreased MNV titers by 0.25-1.44 log TCID50/ml. The maximum titer reduction (4.51 log TCID50/ml) was achieved when the FCV was treated at 37oC with 0.1% of zataria EO.Conclusion: The reduction on the infectivity titers found for the tested norovirus surrogates with these EOs highlighted their potential role as biopreservatives to improve food hygiene and shelflife.

Background and purpose: Phytic acid plays a major role in reducing the bioavailability of minerals in food. The aim of this study was to evaluate the effect of controlled sourdough fermentation on reduction of phytate content in dough and bread produced by whole wheat flour containingLactobacillus plantarumand Lactobacillus brevis.Materials and methods: This experimental study was carried out as a joint project in Golestan University of Medical Sciences and Gorgan University of Agricultural Sciences and Natural Resources.After isolation of two dominant lactobacillus isolates from whole wheat sourdough and their molecular identification, the effect of controlled sourdough fermentation (dominant isolates were used as starter culture, under treatments (as separate or mixed with equal proportions) of 28, 32, 36 °C fermentation temperatures and 16, 24, 32 h fermentation times) was examined on phytate content of produced dough and bread, using a spectrophotometric assay based on the measurement of iron.Results: Sequencing of PCR products led to identification of Lactobacillus plantarum and Lactobacillus brevisas the dominant lactobacillus isolates from whole wheat sourdough. According to statistical analysis, by increasing fermentation time and temperature, the amount of phytate significantly decreased in dough and bread produced by each of dominant isolates (P≤ 0.05). Furthermore, mixture of lactobacillus as starter culture was more effective on phytate reduction compared with using them separately.Conclusion: Our results showed that controlled fermentation of whole wheat sourdough have significant effect on reduction of phytate and increasing the bioavailability of bread minerals.

Background and purpose: Experimental autoimmune encephalomyelitis (EAE) is an animal model of multiple sclerosis. The hallmark of this disease is an autoimmune neuroinflammation induced by autoreactive lymphocytes attack. Pervious documents indicated that phenytoin can protect axonal loss in EAE. Here, we investigated the immunomodulatory effects of phenytoin in EAE.Materials and methods: In this experimental study, EAE was induced by guinea pig spinal cord homogenate and complete Freund’s adjuvant in Wistar rats. The animals were then divided into two therapeutic groups (n=7 per group). Phenytoin therapy (50 mg/kg-daily) was started in treatment group at day 12 when the treatment group developed a disability score. EAE control mice received vehicle alone on the same schedule. Signs of disability were monitored daily until day 36 when mice were sacrificed.Splenocytes were checked for proliferation by MTT test and cytokine production by ELISA.Results: Phenytoin therapy after the occurrence of clinical symptoms significantly regressed the clinical symptoms and improved the weigh index of EAE rats. Phenytoin significantly decreased the production of pro-inflammatory TNF-a and IL-17 as well as IFN-g in supernatant of spleen cells culture (P<0.001). However, the levels of anti-inflammatory IL-10 were not altered significantly. Lymphocyte proliferation significantly decreased in treatment group compared with that in control group (P<0.001).Conclusion: In addition to direct neuroprotective effects, phenytoin can also improve EAE via modulation of immune responses.

Background and purpose: Pesticide residues in food products is of great concern. Food preparation highly influences the pesticide residue and safety of the food. The aim of this study was to evaluate the effects of storage and different washing solutions on dichlorvos residue in tomato.Materials and methods: A Interventional study was performed in which tomato samples were harvested after 24 h of dichlorvos spraying and their dichlorvos concentration was determined. A group of samples was stored in room or refrigerator temperature for 10 days. Dichlorvos changes were recorded every two days and the samples were washed for 20 s. The changes in dichlorvos residues were recorded again after washing the tomatoes. The second group of samples was immersed for 10, 20 and 30 min in water and solutions of 1, 2 and 3% sodium chloride, acetic acid and sodium bicarbonate. The impact of each treatment on residue was evaluated by gas chromatography equipped electron capture detector.Results: Dichlorvos residue reduced during storage and its concentration in samples stored at room and refrigerator temperature reached to lower than the maximum residual limit (MRL) after 8 and 10 days, respectively. Thirty min of immersion in water and solution of sodium chloride, acetic acid and sodium bicarbonate caused 35.75, 34.62, 14.48 and 92.74% reduction in levels of dichlorvos, respectively. Sodium bicarbonate solution, depending on its concentration and washing time, had the highest impact on dichlorvos removal and acetic acid solution was found to have the lowest effect.Conclusion: In order to remove dichlorvos from tomato and increase its safety, it is necessary to consider the preharvest interval (PHI) and its immersion in alkaline solutions for suitable time.

Background and purpose: Pharmaceutical aspects of mucoadhesion have been the subject of great interest during recent years because it provides the possibility of avoiding either destruction by gastrointestinal contents or hepatic first-pass inactivation of drug. In this study, polysaccharide mucilage derived from the seeds of Plantago major L. (Plantaginaceae family) was investigated for use in matrix formulations containing propranolol hydrochloride.Materials and methods: An experimental study was performed in which the mixture of Plantago majorseeds in 0.1 N HCl was macerated on a heater and was filtered through a cotton cloth.The mucilage was precipitated by ethanol. Then several ratios of the drug-mucilage and drug-mucilagepolymer were prepared. The polymer selected for comparison was HMPCK4M. Drug release, swelling, erosion, hardness, and bioadhesion were evaluated.Results: Maximum bioadhesive strength was observed with F1 and the lowest bioadhesive strength was seen with F6. The results also showed that bioadhesive force decreased with increase in the amount of mucilage. As the amount of mucilage increased initial drug release as well as drug release in the later hours was increased. The lowest and the highest release rate was observed in F1 and F7 with highest amount of polymer and mucilage (70 mg), respectively.Conclusion: P. major seed mucilage could be used as a bioadhessive polymer. This mucilage also controlled the release profile of drug.

Background and purpose: Dyes from textile industry are amongst the major pollutants of the environment that are harmful for both human health and the environment. Azo dyes constitute the largest and the most important class of commercial dyes, accounting for 50% of all commercial dyes. This study investigated the efficacy of Cr-doped ZnO nanoparticles in removal of reactive black 5 (RB5) dye from aquatic solutions in presence of solar radiation.Materials and methods: An experimental laboratory study was done by designing the surfaceanswer test. Cr-doped ZnO nanoparticles were synthesized using co-precipitation method. X-ray diffraction (XRD) and scanning electron microscopy (SEM) were used for characterization of the nanoparticles prepared. Effects of parameters such as pH, nanoparticle dosage, initial RB5 concentration, and contact time on the removal efficiency of RB5 were studied. The remaining concentration of RB5 was analyzed by UV/VIS spectrophotometer at a wavelength of 597 nm. Finally, the statistical analysis of the model was conducted by ANOVA.Results: Results showed that removal efficiency increased by increasing nanoparticle dosage and contact time. Also, we found that removal efficiency decreased by increasing the initial dye concentration and pH. The optimum condition for dye removal was obtained at pH 4, nanoparticle dosage of 1.75 g/L, initial dye content of 112.5 mg/L, and 75 min contact time. In this condition the efficiency removal and desirability were 75.41 and of 0.905, respectively.Conclusion: Removal of textile dyes was found to be quick and effective when using Cr-doped ZnO nanoparticles. Also, designing and performing the experiment (in low frequency) can help in optimizing the efficiency removal of pollutant from aqueous media.

Background and purpose: Various contaminants are released into water resources each year as a results of urbanization and industrialization. Chromium VI is one of the most toxic metals released into the aquatic environments, wastewater, and soil mainly via industrial sewage. The purpose of this study was to evaluate the performance of iron-zirconium/chitosan magnetic nanoparticles composite in removal of hexavalent chromium VI from aquatic environments.Materials and methods: A pilot-study was conducted in laboratory scale. Nancomposites synthesis was done using chemical precipitation and tested by SEM, XRD, and FTIR. Various factors such as contact time (0-720 min), initial pH of the solution (2-12), adsorbent dose (0.4-2 gr), initial concentration of metal (0-10 milligrams per liter), and the system temperature (15-35oC) were studied.The concentration of heavy metal chromium was measured using a spectrophotometer at 540nm.Results: The results showed that the highest removal efficiency of heavy metal chromium was obtained at pH 4.0 (52.99%). Moreover, addition of 1 gr composite in the same concentration could boost removing the hexavalent chromium by more than 91%. Increasing the concentration levels of heavy metals had little impact on the removal efficiency. Adsorption isotherms fitted the Freundlich isotherm.Conclusion: According to the results, the absorbent showed a high performance in removing chromium VI from aquatic environments.

Background and purpose: Multiple line of evidence suggested that diabetes has adverse effects on male sexual and reproductive functions. The aim of present study was to investigate the protective effect of colostrum (COL) on sperm parameters, sex hormones, testes histopathological changes, and oxidative stress in diabetic rats.Materials and methods: In this experimental study, 30 diabetic male Wistar rats were randomly divided into three groups (n=10) and were treated either by saline (model) or COL (100-200 mg/kg). Also, 10 healthy age matched rats were allocated as normal control group which received only saline. The rats in the COL treated groups were given colostrum at 100-200mg/kg once a day orally for 8 weeks. At the end of the study, epididymal sperms were counted, and testis tissues and blood samples were collected for histopathologic and biochemical analysis. Data were analyzed using ANOVA, Kruskal-Wallis and Mann-Whitney tests in SPSS V.18.Results: COL treatment (at both doses) significantly decreased the elevated glucose (P<0.01) and tissue malonaldehyde (MDA) (P<0.05) levels in plasma and testis tissues samples, respectively. The COL treated rats showed an improved histologic appearance (germinal layer thickness, spermatogonia number, seminiferous tubule diameters) and serum testosterone levels.Conclusion: The results clearly provide evidence that CLO treatment can inhibit the progression of reproductive system complication in diabetic rats.

Background and purpose: High cost and complication of some instruments assessing functional capabilities in athletes with anterior cruciate ligament (ACL) deficiency have caused increasing attentions towards using inexpensive and user-friendly instruments as accelerometers and gait analyzing based on signal processing. Therefore, gait phases detection seems to be necessary while accelerometer is mounted on tibia. The aim of this study was to present a novel algorithm based on wavelet functions and dynamic time warping in order to gait detecting and gait breakdown from tibia acceleration raw data.Materials and methods: A semi-experimental study was performed in which swing and stance phases of 20 healthy individuals and 20 ACL-deficient individuals’ gait were detected using up to order 32 of Mexican hat function of wavelet transformation. The acceleration signals were divided o peak searching parts. Time domain analyses were performed using peak detectors and dynamic time warping functions.Results: In normal individuals and ACL-deficient subjects, 376 and 392 strides were detected from 391 and 415 strides, respectively. Also, in normal individuals from 17 distorted strides 14 and in those with ACL-deficiency all distorted strides were completely corrected.Conclusion: The suggested algorithm was found to be capable of detecting swing and stance phases of the gait in both normal and ACL-deficient patients by accuracy rates of 94% and 95%, respectively. These rates are higher compared with previous studies. This novel algorithm could be applied as a useful method for gait evaluation in healthy people and individuals with ACL-deficiency.

Background and purpose: Many people with oral and dental diseases will see their physicians first, therefore, doctors must have enough knowledge about primary medical treatments. This research was conducted to study the knowledge of medical interns in Sari, Babol, and Mashhad medical schools about oral and dental diseases and also dental emergencies in 2013-2014.Materials and methods: An analytical cross-sectional study was performed in 98 medical interns. A questionnaire was designed based on the books, scientific sources and available articles in this field. Content validity of the questionnaire was determined by four specialists. In order to evaluate the reliability of the questionnaire, the Test-retest method was used and the spearman correlation coefficient was 0.8. Data analysis was done in SPSS V.20 applying, ANOVA and Tukey test. P<0.05 was considered significant.Results: The mean score for students' knowledge was 8.3. The mean knowledge scores of medical interns about oral and dental diseases were significantly different between the universities (P<0.004). The mean score was found to be higher in students at Babol University of Medical Sciences.Conclusion: Low level of knowledge in oral and dental diseases among medical interns calls for further studies that could identify the factors causing this problem. Also, more training courses for interns and retraining of physicians are required.

Background and purpose: Valproic acid (VPA) is used worldwide as a major drug in the intervention of epilepsy and in control of several kinds of seizures. The aim of our investigation was to evaluate the nephrotoxic potential of VPA and protective effects of zinc and selenium against VPAinduced nephrotoxicity in Wistar rats.Materials and methods: In this study, the animals were divided into five groups: control, VPA (200 mg/kg IP), VPA+Zn (10 mg/kg IP), PA+Se (1 mg/kg IP), and VPA+Zn+Se. After the administration of VPA for 4 consecutive weeks, the animals were killed and kidney tissues were separated. Finally, oxidative stress markers including glutathione (GSH) content, lipid peroxidation (LPO), protein carbonyl (PCO) were measured and blood was taken for measuring biochemical markers (BUN and Cr).Results: The administration of VPA for 4 consecutive weeks resulted in an increase in kidney marker (BUN and Cr). Also, oxidative stress was evident in VPA group by increased lipid peroxidation (LPO), protein carbonyl (PCO) and glutathione (GSH) oxidation. Zn and Se administration was able to protect against deterioration in kidney markers and suppressed the increase in oxidative stress markers.Conclusion: Our study showed the critical role of oxidative damage in Valproate-induced nephrotoxicity that markedly inhibited by administration of Zn and Se. Therefore, Zn and Se supplementation could be suggested for prevention of valproate-induced nephrotoxicity.

Background and purpose: Toxoplasmosis infection in hemodialysis patients may cause severe complications, and even in some cases the cause of death. It can be impose considerable costs to health systems. Since the high prevalence of this parasite has been reported in various parts of the country, this study was conducted to determine the prevalence of toxoplasmosis in hemodialysis patients in Bushehr, Iran.Materials and methods: In this cross-sectional study, all hemodialysis patients who were continuously referred from September 2011 to September 2012 to the dialysis center at Bushehr, were evaluated by the ELISA method for determine the presence of anti-Toxoplasma IgG & IgM antibodies.Results: From a total of 84 patients studied, 32 (38.1%) and 2 (2.4%) patients were positive for IgG and IgM antibodies, respectively. The results showed that there is no significant relationship between infection and some variables analyzed, such as consuming and washing vegetables and keeping cats.Conclusion: Considering the high prevalence of toxoplasmosis infection among hemodialysis patients in Bushehr in comparison with healthy people in the region and since the fact that toxoplasmosis is a risk factor for life-threatening of hemodialysis patients, it is recommended that these patients should be screen for toxoplasmosis before dialysis as well as kidney transplant to prevent the spread of the infection through the process of dialysis.

Background and purpose: Scorpionism is a life-threatening hazard in many parts of the world including Iran. Identifying the epidemiology of effective factors causing this health problem could play a major role in its prevention. Therefore, this study was conducted to understand the epidemiology of scorpionism in Darmian, Iran.Materials and methods: A retrospective cross-sectional study was designed in which all the people stung by scorpion between March 2015-2016 were investigated. The subjects were residing in Darmian, Southern Khorasan province, Iran. Epidemiology of patients and demographic data were collected in a checklist and data was analyzed in SPSS V.20.Results: A total of 132 cases stung by scorpion were recorded including 58 males (43.9%) and 74 females (56.1%). The highest and lowest rates were found in people aged 35-44 (22%) and≥65 (6.8 %), respectively. Among the cases 3.8% were younger than 15 years of age. Hands, legs, and head and face were the most prevalent sting sites (47.7%, 39.4% and 12.9%, respectively). Most cases of scorpion stings occurred during spring and summer while July was the month with highest rate (22%). Of totalcases 29.5% were residing in urban areas and 70.5% were in rural areas.Conclusion: The highest rate of scorpionism cases were reported in rural areas, therefore, training programs should be considered for preventing scorpionism in rural communities. Also, development and optimization of residential houses and rural roads can greatly reduce the incidence of scorpion stings.

Background and purpose: Breast Cancer is one of the health problems in every population.The aim of this study was to determine the frequency of BRCA1 and BRCA2 common mutations in women whose mothers were diagnosed with breast cancer.Materials and methods: A case–control study was performed in 109 females (less than 40 years of age) who had mothers with breast cancer. For scanning of genomic mutations in BRCA1 and BRCA2, genes mutation analysis was done in BRCA1 (exon2, 20) and BRCA2 (exon11) using Real Time PCR test. We also studied 109 healthy controls without family history of breast cancer.Results: No any mutation was found in this population.Conclusion: This study showed no mutation in affected and control group. Therefore, other mutations and genes may have a role in breast cancer pathogenesis in our population.

Background and purpose: Myricetin as a natural flavonoids in tea and coffee, has extensive pharmacological effects. Endosulfan is mutagenic and is capable of inducing genetic damage in human blood cells. The aim of this study was to investigate the protective effect of myricetin against DNA damage caused by endosulfan on human blood lymphocytes.Materials and methods: Blood samples after 3 hours of incubation with different concentrations of myricetin, were incubated with Mm10 endosulfan for 24 hours. Then, to evaluate the production of micronucleus in binucleated lymphocytes, the slides were prepared and were evaluated by light microscopy. The mean values were compared using PRISM and ANOVA (posttest: Tukey).Results: The incubation of blood samples with Endosulfan induced additional genotoxicity in lymphocytes, and Myristin pretreatment significantly reduced the micronucleus frequency (P<0.01). The results showed the effective role of Myristin as protective agent in reducing the genotoxicity of the pesticide Endosulfan.Conclusion: Myristin appeared to scavenge and trap free radicals to prevent the damage induced by ROS. It is a natural compound and is considered to be safe, therefore, it can be used as a supplement to protect people exposed to chemical or environmental hazards.

Background and purpose: In recent years the use of radioactive materials for diagnostic and therapeutic purposes grew rapidly in nuclear medicine. The imaging technicians and nursing staff in radiopharmaceutical centers are in close contact with patients. Therefore, they are exposed to different radiation levels. This study was done on risk assessment of staff exposed to 99mTc-MIBI Materials and methods: In this study, the radiation dose rate from two groups of patients (rest patients n=27 and rest patients n=23) who received99mTc-MIBI for myocardial perfusion imaging was measured using detection at different distances in Shahrood Imam Hospital, Iran. Then, the radiation dose rate of the staff was calculated based on the duration of time they were exposed to radiation at different distances.Results: The value of radiation dose rate from patients receiving 99mTc-MIBI for stress and rest patients were 9.9 and 13.4 micro Sv per hour in 25 cm distance from patients, respectively. By calculating the mean time of technicians’ close contact (less than a meter) with patients, their mean daily exposure rate was found to be 2.1±1.2 and 2.9±1.2 micro Sv per hour for rest and stress patients, respectively.Conclusion: Compared with threshold level (60 micro Sv per day) lower levels of radiation exposure was seen in our population. But generally, the exposure rate in rest patients was found to be higher.

Background and purpose: Oral lichen planus is a chronic inflammatory disease of the oral mucosa. The exact cause is not yet well understood. Possible associations have been suggested between blood groups and susceptibility to various diseases. This study investigated the distribution of ABO blood groups and Rh system in patients with oral lichen planus in Iran.Materials and methods: In a cross-sectional study, 100 patients with oral lichen planus attending Oral Medicine Department in Shahid Beheshti dental school, Tehran, were examined. ABO blood groups and Rh type were recorded. Data was analyzed in SPSS V.18 applying Chi-square test.Results: Among 100 patients, 38 (38%) had blood group O and others had blood group A (28%), B (18%), and AB (16%), respectively. Also, 96 patients were Rh-positive while four were Rh-negative.Conclusion: Patients with oral lichen planus in this study had higher distribution of O blood group than other blood groups. Also, most of them were Rh-positive.

Background and purpose: Today medicinal plants have received much attention in treatment of many cancers.Juglans regia has phenolic compounds and is used in cytotoxicity studies. This study investigated the effects of hydroalcoholic extract of Juglans regia on the growth of human cervical and liver cancer cells.Materials and methods: The hydroalcoholic extract of the fruit of Juglans regia was prepared by percolation method. The HeLa and HepG2 cancer cells were cultivated and further incubated with different concentrations of the extract. After 72 hours, cell growth inhibition was examined using MTT assay. The results were statistically analyzed in Prism ver.3 applying ANOVA and post-test.Results: The inhibitory concentration 50 (IC50) of the plant extract on human HepG2 and HeLa cancer cells were 449.1 ± 18.26 mg/ml and 222.4 ± 2.66 mg/ml, respectively. The IC50of Cisplatin on these cancer cells were found to be 15.96±1.117and 15.79±1.147 mg/ml, respectively.Conclusion: The IC50of Juglans regia on HeLa and HepG2 was more than that in Cisplatin.Accordingly, further investigations are needed on other cancer cell lines. Moreover, due to the fact that the extract was total, future studies should aim at identifying its active substances.

Background and purpose: Milk has an essential role in human health and its proper consumption is one of the indices of healthy nutritional style. This study was designed to assess the contamination of pasteurized milk and dairy products by different pathogenic microbes in Zahedan, Iran.Materials and methods: In an analytical cross-sectional study, 551 samples including 244 pasteurized milk, 165 pasteurized yogurts, and 142 pasteurized yogurt drinks were randomly obtained during 10 months. They were tested using national standard method.Results: According to the results, 86.9% and 13.1% of pasteurized milk were found to be acceptable and unacceptable for human consumption, respectively. In this study 81.8% and 95.1% of yogurts and yogurt drinks were acceptable and 18.2% and 4.9% were unacceptable for human consumption, respectively. The main microbial contamination was associated with S. aureus (45.4%).The majority of milk samples unacceptable for human use were observed in summer (23%) and spring (13.3%).Conclusion: The quality of most of the pasteurized dairy products was found to be good, however, there are still problems in the region with factors predisposing to microbial contamination.

Background and purpose: Intensive care unit (ICU) nurses play an important role in nonpharmacological prevention of ventilator-associated pneumonia (VAP). The aim of this study was to assess the knowledge of nurses in ICU about non-pharmacological prevention of ventilator-associated pneumonia.Materials and methods: In a descriptive cross-sectional study, 120 ICU nurses were studied in teaching hospitals of Mazandaran University of Medical Sciences, 2015. Demographic information of nurses were recorded including age, sex, duration of being in ICU and their educational level. An authentic multiple-choice questionnaire was administered to assess the nurses' knowledge about the prevention of VAP.Results: 120 nurses including 96 females and 24 males (mean age: 32.39±5.57, mean work experience: 5.94±4.5 years) were studied. The average number of beds in the studied ICUs was 9.53±1.97 beds (Median=9). Percentage of correct answers of nurses on the oral route for intubation, frequency of ventilator circuit changes, type of airway humidifier, frequency of humidifier changes, type of suction system, frequency of change in suction systems, drainage of subglottic secretions, kinetic vs. standard beds, and patients positioning were 81.7%, 53.3%, 42.5%, 6.7%, 62.5%, 38.3%, 30%, 46.7%, and 85.8%, respectively. The average score of the participants was 4.48±1.69 out of 9.Conclusion: ICU nurses' knowledge about the type of humidifier, switching frequency of humidifier, switching frequency of suction system, subglottic secretion drainage, and the type of bed was found to be very low. These findings call for continuous training and assessment to promote the knowledge of nurses in ICUs for non-pharmaceutical prevention of VAP.

Neuroendocrine carcinoma (NEC) of stomach is a rare and highly malignant tumor. It rarely occurs in the gastrointestinal (GI) tract especially in stomach. In this report, an 81-year-old male is presented with chief complaint of epigastric pain and early satiety. Endoscopic examination of the upper GI tract revealed an ulcerative mass measuring 3x4x4 cm in body of stomach, and a biopsy was taken.Accordingly, poorly differentiated neuroendocrine carcinoma was observed on microscopic examinations.On immunohistochemical staining, neuroendocrine carcinoma was confirmed. After six cycles of chemotherapy the primary tumor size declined and also improvement of hepatic metastasis was observed.Due to acceptable responses of these tumors to therapy, clinical and morphological evaluations along with specific staining are necessary.

Acanthamoebais a free-living amoeba that is an opportunistic pathogen of humans and animals.Its prognosis is potentially poor that requires fast diagnosis and successful treatment. There are two phases in its life cycle: an active trophozoite form and the double-walled resistant cyst. This amoebic genus is the causative agent of two severe diseases in humans: Acanthamoeba keratitis (AK) and fatal granulomatous amoebic encephalitis (GAE).Acanthamoeba cysts almost remain viable after treatments and lead to serious and frequent recurrence of infection. Resistance of the double walled cysts is mainly due to cellulose molecules presented in the inner layer of the cysts. Thus, cellulose degradation or inhibiting the cellulose synthesis offers a potential strategy for effective treatment ofAcanthamoeba. In this non-systematic review we aimed at providing an overview of the cellulose structure, its role in skeletal structure and also physicochemical activity of the protozoa and present it as new drug target for the treatment of amoebic infection. Overall, the degradation of the cyst wall will make amoeba susceptible to chemotherapeutic drugs, and at least inhibition ofAcanthamoeba excystment, consequently it prevents the recurrence of infection. Furthermore, cellulose synthesis inhibitors cause current drugs to affect onAcanthamoeba in lower time and concentrations. Therefore, using compounds or drugs that inhibit the synthesis of cellulose can be a new treatment for amoebic infections.

Background and purpose: Diabetes mellitus is one of the most common endocrine complications in thalassemic patients. Several studies investigated the prevalence of diabetes in Iranian patients with thalassemia major and reported different results but no overall estimate was calculated. Therefore, we conducted a meta-analysis to study the prevalence of diabetes in patients with thalassemia major in Iran.Materials and methods: This review study was conducted by PRISMA checklist. Electronic databases including Magiran, Iranmedex, SID, Medlib, IranDoc, Scopus, Pubmed, Science direct, Cochrane, Web of Science, Springer, Online Library Wiley and Google Scholar were searched in chronological order without time limit, in January 2016, using relevant keywords. Two researchers independently performed article selection and data extraction. All studies meeting our inclusion criteria were investigated. Data analysis was done using random effect model in Stata Ver.11.1.Results: Overall, 6380 patients were studied in 42 articles. Prevalence of diabetes in patients with thalassemia major in Iran was 9.5% (CI: 95%, 7.8-11.3). The minimum and maximum prevalence of diabetes were found in West (10.3%) and North of Iran (8.3%), respectively. The prevalence rate in male and female thalassemia major patients were 12.6% (CI: 95%, 6.1-19.1) and 10.8% (CI: 95%, 8.2-14.5), respectively.Conclusion: Prevalence of diabetes in Iranian patients with thalassemia major was found to be high. Therefore, routine blood tests should be done every six-month for early diagnosis of diabetes in this population.